5 : Community-Onset Oxacillin-Resistant Infection

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Community-Onset Oxacillin-Resistant Infection, Page 1 of 2

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The osteomyelitic lesions of Egyptian mummies, the wound infections of medieval soldiers, and contemporary outbreaks of neonatal sepsis all point to one fact: is as old as medicine and is an extremely successful pathogen, capable of causing invasive disease at all stages of life. The genotypic changes responsible for the confer cross-resistance to virtually all beta-lactam antimicrobials, including oxacillin and the other antistaphylococcal beta-lactams that are now most often prescribed. The recent whole-genome sequencing of strongly supports the concept that horizontal gene transfer is a common evolutionary mechanism in , even though staphylococcal cassette chromosome (SCC) transfer itself may only rarely occur; hence, horizontal transfer of or SCC is a plausible hypothesis to account for emergence of community-acquired oxacillin-resistant (ORSA) isolates that are dissimilar to health care setting acquired isolates. The clinical implications are obvious: treatment failure with accompanying complications or death may result if an antistaphylococcal beta-lactam antibiotic is used for serious infections and the infecting strain proves to be resistant; infections caused by oxacillin-resistant strains may be more difficult to manage or more expensive to treat, in part because vancomycin is inherently less efficacious; and the increasing prevalence of ORSA will inevitably increase vancomycin use, adding further to the problem of antimicrobial-resistant gram-positive bacteria. Immediate and widespread action to reduce vancomycin use can halt the emergence of fully resistant strains, increasing prevalence of the strains in health care settings, and then their eventual emergence in community settings.

Citation: Gerberding J, Chambers H. 2001. Community-Onset Oxacillin-Resistant Infection, p 85-94. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch5

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DNA Restriction Enzymes
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Figure 1

Proportion of hospital-onset infections resistant to oxacillin (based on data from the National Nosocomial Infections Surveillance System, 1989 to 2000).

Citation: Gerberding J, Chambers H. 2001. Community-Onset Oxacillin-Resistant Infection, p 85-94. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch5
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1. Adcock, P. M.,, P. Pastor,, F. Medley,, J. E. Patterson,, and T. V. Murphy. 1998. Methicillin-resistant Staphylococcus aureus in two child care centers. J. Infect. Dis. 178:577580.
2. Barber, M.,, and M. Rozwadowska-Dowzenko. 1948. Infection by penicillin-resistant staphylococci. Lancet i:641644.
3. Boyce, J. M. 1989. Methicillin-resistant Staphylococcus aureus: detection, epidemiology, and control measures. Infect. Dis. Clin. N. Am. 3:901913.
4. Burney, L. E. 1958. Staphylococcal disease: a national problem, p. 310. In Hospital-Acquired Staphylococcal Disease: Proceedings of the National Conference, September 15-17, 1958, Atlanta, Ga.
5.Centers for Disease Control and Prevention. 1999. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus—Minnesota and North Dakota, 1997-1999. Morb. Mortal. Wkly. Rep. 48:707710.
6.Centers for Disease Control and Prevention. 1997. Reduced susceptibility of Staphylococcus aureus to vancomycin—Japan, 1996. Morb. Mortal. Wkly. Rep. 46:624626.
7.Centers for Disease Control and Prevention. 1997. Staphylococcus aureus with reduced susceptibility to vancomycin—United States, 1997. Morb. Mortal. Wkly. Rep. 46:765766.
8.Centers for Disease Control and Prevention. 2000. Staphylococcus aureus with reduced susceptibility to vancomycin—Illinois, 1999. Morbid. Mortal. Wkly. Rep. 48:11651167.
9. Conterno, L.O.,, S. B. Wey,, and A. Castelo. 1998. Risk factors for mortality in Staphylococcus aureus bacteremia. Infect. Control Hosp. Epidemiol. 19:3237.
10. Crossley, K.,, B. Landesman,, and D. Zaske. 1979. An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. II. Epidemiologic studies. J. Infect. Dis. 139:280287.
11. Gentry, C. A.,, K. A. Rodvold,, R. M. Novak,, R. C. Hershow,, and O. J. Naderer. 1997. Retrospective evaluation of therapies for Staphylococcus aureus endocarditis. Pharmacotherapy 17:990997.
12. Gould, J. C.,, and J. D. Cruikshank. 1957. Staphylococcal infection in general practice. Lancet ii:11571161.
13. Hahn, D. L.,, and W. A. Baker. 1980. Penicillin G susceptibility of ‘‘rural’’ Staphylococcus aureus. J. Fam. Pract. 11:4346.
14. Harris, D. M.,, and P. J. Wise. 1969. Penicillinase producing staphylococci in general practice and their control by cloxacillin. Practitioner 203:207211.
15. Herold, B. C.,, L. C. Immergluck,, M. C. Maranan,, D. S. Lauderdale,, R. E. Gaskin,, S. Boyle-Vavra, et al. 1998. Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk. JAMA 279:593598.
16. Hiramatsu, K. 1995. Molecular evolution of MRSA. Microbiol. Immunol. 39:531543.
17. Hiramatsu, K.,, T. Ito,, and H. Hanaki. 1999. Mechanisms of methicillin and vancomycin resistance in Staphylococus aureus. Bailliere’s Clin. Infect. Dis. 5:221242.
18. Hiramatsu, K.,, T. Ito,, I. Uchiyama,, T. Baba,, H. Yazawa,, I. Kobayashi,, L. Cui,, A. Oguchi, et al. 2001. Whole genome sequencing of methicillin-resistant Staphylococcus aureus. Lancet 357: 12251240.
19. Hughes, G. B.,, C. C. Chidi,, and W. L. Macon. 1976. Staphylococci in community-acquired infections: increased resistance to penicillin. Ann. Surg. 183:355357.
20. Jessen, O.,, K. Rosendal,, P. Bulow,, V. Faber,, and K. R. Eriksen. 1969. Changing staphylococci and staphylococcal infections: a ten-year study of bacteria and cases of bacteremia. N. Engl. J. Med. 281:627635.
21. Katayama, Y.,, T. Ito,, and K. Hiramatsu. 2000. A new class of genetic element, staphylococcus cassette chromosome mec, encodes methicillin resistance in Staphylococcus aureus. Antimicrob. Agents Chemother. 44:15491555.
22. Kirby, W. M. M. 1944. Extraction of a highly potent penicillin inactivator from penicillin resistant staphylococci. Science 99:452453.
23. Knight, W.,, A. White,, and T. Hemmerly. 1958. Staphylococcal disease: a national problem, p. 3953. In Hospital-acquired Staphylococcal Disease: Proceedings of the National Conference, September 15-17, 1958, Atlanta, Ga.
24. Kreiswirth, B.,, J. Kornblum,, R. D. Arbeit,, W. Eisner,, J. N. Maslow,, A. McGeer, et. al. 1993. Evidence for a clonal origin of methicillin resistance in Staphylococcus aureus. Science 259:227230.
25. Layton, M. C.,, W. J. Hierholzer, Jr.,, and J. E. Patterson. 1995. The evolving epidemiology of methicillin-resistant Staphylococcus aureus at a university hospital. Infect. Control Hosp. Epidemiol. 16:1217.
26. Payne, M. C.,, H. F. Wood,, W. Karakawa,, and L. Gluck. 1966. A prospective study of staphylococcal colonization and infections in newborns and their families. Am. J. Epidemiol. 82:305316.
27. Ross, S.,, W. Rodroguez,, G. Controni,, and W. Kahn. 1974. Staphylococcal susceptibility to penicillin G: the changing pattern among community isolates. JAMA 229:10751077.
28. Saravolatz, L. D.,, D. J. Pohlod,, and L. M. Arking. 1982. Community-acquired methicillin-resistant Staphylococcus aureus infections: a new source for nosocomial outbreaks. Ann. Intern. Med. 97: 325329.
29. Saravolatz, L. D.,, N. Markowitz,, L. Arking,, D. Pohlod,, and E. Fisher. 1982. Methicillin-resistant Staphylococcus aureus. Epidemiologic observations during a community-acquired outbreak. Ann. Intern. Med. 96:1116.
30. Small, P. M.,, and H. F. Chambers. 1990. Vancomycin for Staphylococcus aureus endocarditis in intravenous drug users. Antimicrob. Agents Chemother. 34:12271231.
31. Soriano, A.,, J. A. Martinez,, J. Mensa,, F. Marco,, M. Almela,, and A. Moreno-Martinez. 2000. Pathogenic significance of methicillin resistance for patients with Staphylococcus aureus bacteremia. Clin. Infect. Dis. 30:368373.
32. Thompson, R. L.,, I. Cabezudo,, and R. P. Wenzel. 1982. Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann. Intern. Med. 97:309317.

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